USMLE Step 3: 199 - screwed for residency??

[AthenaBC]

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Hi guys,
I haven't taken any of the steps yet (currently studying for Step 1), but this is for my cousin who is very worried. He applied this year and didn't get into any residency programs, but he's very interested in General Surgery. Here's his info:
Step 1: 235
Step 2: 239
Step 3: 199 (especially worried about this because it seems quite low!)
- He's an IMG who graduated in 2011
- He's here in the US on a student visa
- He completed a year of internship in a hospital abroad after completing med school
- He has done observerships/externships in General Surgery and Internal Medicine in hospitals in America for the past year

It's worrisome since he put in so much effort, so do you think he has a shot at getting into General Surgery? If not, then are there any programs who will take him?

 

[DrZzZz]

IMG here (technically Caribbean schooled, but US born). To me, what's more concerning for him than the Step 3 score is the fact he graduated in 2011 and is still without a residency (ignoring the intern year abroad). At one of my interviews for a prelim IM spot this year (at a pretty undesirable program, mostly a backup for me), the PD asked me my opinion on other Caribbean grads and those trying to apply so long after their graduation. She told me if she sees they've been graduated for more than 1 year on their application, it gets tossed regardless of their scores. Again, this was a hospital that doesn't get many (if any) applications from US MDs for their categorical spots, and few US MDs for their prelim spots. The fact that he has stayed busy with observerships in the US is good, but certainly won't "cure" the fact he has not gotten a residency in the US to this point in time.

As far as the Step 3, did he take it during/after that intern year abroad? If so, that would concern me as a PD and point to the fact that his intern year wasn't very strong/useful for him. If he took it more recently, it may point to the fact that his skills/knowledge base have faded since graduating 3 years ago.

All of that considered, here's my advice for him: if he does want to apply again, make sure to be willing to take on the least desirable locations/programs. Apply very broadly (ie. don't narrow your scope to any particular region of the US, apply for both prelim and categorical spots, etc), but don't waste $ on applications to strong university programs. Remember that Gen Surg is pretty competitive, so he may need to consider the less competitive specialties (Family, Psych, etc). In the meantime, try to get good, personal LORs from US dr's he's been working with. Get help writing the personal statement if his English is not strong. Make sure to apply for the Match as soon as it opens in September. Don't waste any time, as some programs give out all their interview offers early in the process. By late October, make sure to email/call programs who haven't responded to his application (I got quite a few interviews at programs who I made first contact with after applying, including the program I ended up matching at). And for the interviews, make sure to be prepared for every question you can think of being asked (there are plenty of books and websites to help with that), ESPECIALLY about the Step 3 score and the fact he graduated back in 2011, but is still applying for residency.

If he has any other specific questions, I'd be happy to help. Best of luck.

 

[Instatewaiter]

Hi guys,
I haven't taken any of the steps yet (currently studying for Step 1), but this is for my cousin who is very worried. He applied this year and didn't get into any residency programs, but he's very interested in General Surgery. Here's his info:
Step 1: 235
Step 2: 239
Step 3: 199 (especially worried about this because it seems quite low!)
- He's an IMG who graduated in 2011
- He's here in the US on a student visa
- He completed a year of internship in a hospital abroad after completing med school
- He has done observerships/externships in General Surgery and Internal Medicine in hospitals in America for the past year

It's worrisome since he put in so much effort, so do you think he has a shot at getting into General Surgery? If not, then are there any programs who will take him?

It is very worrisome that it has been 3 years since he graduated... and still no residency. The step III doesn't help. He should apply very broadly and also broadly to a backup specialty like FM/Psych